Come on, ‘fess up ladies. How much attention did you pay to your pelvic floor exercises during pregnancy and after birth?
If the answer’s ‘very little’ or even ‘none at all’, you’re not alone. In fact, you may well be in the majority. If memory serves, my own efforts to keep up with those tedious little squeezes in the pre and post-natal period were half-hearted, to say the least.
Maybe, like me, you neglected yours because they were boring. But maybe you also neglected them because nobody pointed out precisely how important they might prove to be a bit later – or outlined what the worst case scenario could be if you ignored them.
Fact is, these exercises (Americans call ‘em ‘Kegels’, after the obstetrician who pioneered them) really can make a difference. The pelvic floor is a ‘sling’ of muscles which support the bladder, bowel and uterus and inevitably it comes in for a massive hit during pregnancy and birth. Working to strengthen it can help prevent – and resolve – a number of conditions that include incontinence, pelvic instability and back pain, and prolapse, which occurs when one of the pelvic organs drops down into the vagina causing, as you can imagine, all sorts of further issues. (As a useful aside, keeping your pelvic floor strong can also make for a better sex life)
‘The process of carrying a baby takes its toll on the pelvic floor and it you then have a vaginal birth it takes a further pounding. So if you’re a mum and you don’t exercise your pelvic floor, you risk some serious problems – if not now, then as you age,’ warns Wendy Powell, a pre and postpartum exercise specialist who developed the MuTu System, a programme specifically aimed at core and pelvic restoration. http://mutusystem.com
It’s important to get them right, though, Wendy stresses. ‘Standard advice is to squeeze as if you’re trying not to a wee, but it’s a complicated system of muscles down there and ideally the pelvic floor needs to be trained and exercised as part of the entire core system of muscle, not just as isolated squeezes,’ she says. ‘You have to remember to lift from the middle and the back as well as the front, exhaling through pursed lips as you do it, drawing your belly button towards your spine at the same but without tucking your tailbone in.’ (There’s more detailed advice from Wendy on how to do pelvic floor exercises right in her blog, which you can find here: http://mutusystem.com/category/body-confidence-after-having-a-baby/pelvic-floor-exercises-kegels)
Most mums I’ve talked to agree there’s not enough information or guidance given on pelvic floors and the importance of exercising them. I tapped a panel of real mums for their comments and views whilst writing First Time Mum, and one of them, Rebecca F, told me: ‘No-one explained to me why you need to do your pelvic floor exercises, and because I didn’t, I had a prolapse, two years after having my second child. Not the most serious kind, but enough to cause problems that needed physiotherapy to resolve. Your bottom falling out of your bits is not a consequence of birth you expect, and I think there’s a huge conspiracy of silence about it.’
Emma Goodman, a mum-of-two and a pregnancy and postnatal personal fitness trainer who blogs at http://www.preandpostnatalexercise.co.uk/category/blog/, agrees it’s a subject that’s often neglected.
‘Exercise instructions may be handed out on a scrappy bit of paper, or plopped in with a heap of other leaflets as you leave the hospital, which doesn’t entice you to get them done,’ she says. ‘I think it would be helpful for expectant or new mums to attend a quick practical workshop, where they could ask questions.’
Why don’t health professionals in the UK make a bigger deal about the importance of pelvic floor exercises for women who are either expecting, or have just had, a baby? I couldn’t say. I’m told that in France, it’s an issue of such national importance that all mums are routinely offered a series of free postnatal physiotherapy appointments aimed at getting the pelvic floor back in shape: La rééducation périnéale. (Although by all accounts, this is less about avoiding health problems and more about getting women back in the sack again http://www.guardian.co.uk/lifeandstyle/2009/mar/26/france-postnatal-care-sexual-health, as soon as possible!)
Of course, we can’t entirely blame the health professionals. Ultimately, it’s up to us to make sure our pelvic floors get exercised – preferably every day, a couple of times a day.
‘It’s not something you’d ever make an appointment to do and that’s why it’s easy to neglect them,’ says Emma. ‘Your best bet is to fit your pelvic floor exercises alongside regular daily activities that you carry out at the same time – brushing your teeth, having a shower, waiting at the bus stop, or sitting on the train, for example. That way you’re guaranteed to do them every day.’
And when can we all stop doing our pelvic floor exercises? Ladies, the truth is that, ideally, you would carry on doing them forever. The pelvic floor is a muscle like any other, and if you stop making it work, it will get weak – particularly as the years roll on!
So. Altogether now. Squeeeeeeeze!
Thank you Hollie! Hollie’s website is over here with loads of information about her books – check out our reviews – we love her books!
‘Somewhere, hidden amongst thorny brambles is a little kingdom of Elves and Fairies. Everyone who lives here is very, very small…’
First-time Mum is the follow-up to Pregnancy for Modern Girls